BROCKTON – When an opiate addict emerges from a dangerous stupor after being given Narcan, they may lash out violently or projectile vomit. Or they may say they feel fine and refuse more medical treatment. “It’s imperative they go to the hospital,” Dr. Dan Muse said.

Dr. Muse, an emergency physician at Signature Healthcare Brockton Hospital, urged a room of police and court officials gathered this week for a Narcan “train the trainer” session to be aware that once the effects of the opiate overdose-reversal drug wear off, a user can easily slide back into an overdose.

That lesson may soon find an even wider audience.

Last month, Gov. Deval Patrick said he would make Narcan available to all first responders. Meanwhile, doctors, public officials and families touched by the region’s opiate epidemic have been pushing to make Narcan available over the counter.

On Thursday, the U.S. Food and Drug Administration gave early approval to a device that rapidly delivers a single dose of naloxone, the generic name for Narcan. The hand-held device “can be carried in a pocket or stored in a medicine cabinet” and is intended for family members or caregivers.

“Making this product available could save lives by facilitating earlier use of the drug in emergency situations,” Bob Rappaport, the FDA doctor in charge of addiction products, said in a statement.

The FDA announcement echoed Dr. Muse’s warning, saying that the device, Evzio, is “not a substitute for immediate medical care, and the person administering Evzio should seek further, immediate medical attention on the patient’s behalf.”

Right now, acquiring Narcan requires a doctor’s order. But area health care providers are working to expand its availability.

“It should be over the counter for anyone who wants it,” said Dr. Ken Lawson, the chief of emergency medicine at Signature Healthcare Brockton Hospital.

Overdose patients who are discharged from the hospital are provided information about Narcan and, if appropriate, prescriptions for the nasal form of the drug, Dr. Lawson said.

“More Narcan equals more people getting treatment,” said Dr. Barbara Herbert, chief of addiction medicine at St. Elizabeth’s Medical Center in Brighton.

“There is a real push to get first responders on board,” Dr. Herbert said. “Is that enough? No. Every grandmother in the state should have it. It should be in everybody’s drug cabinet.”

Once turned on, the device fast-tracked by the FDA provides verbal instruction to the user describing how to deliver the medication, similar to automated defibrillators. Family members or caregivers are encouraged to practice with a trainer device provided with the main device before they use it for the first time, the FDA said.

Page 2 of 2 - It takes one to three minutes on average for Narcan to kick in, and then wears off in as few as 30 minutes or as long as two hours, Dr. Muse said. Once the Narcan dissipates, opiates are free to return to their preferred receptors in the brain, re-igniting a euphoric high and also severely depressing breathing.

That said, Dr. Muse encouraged the first responders attending the Brockton training session Friday to use Narcan liberally, even if they do not know exactly what the victim consumed.

“It’s the equivalent of using nasal spray,” Dr. Muse said. “There’s only upside to it.”

In Quincy, where the Police Department has been a national leader in equipping its officers with Narcan, the drug has been administered 250 times since October 2010, leading to 239 successful overdose reversals, Lt. Patrick Glynn said.

Glynn spoke Friday about an officer who reversed two overdoses in two hours. One was a 17-year-old boy who had been left in a snowbank by his friends, the other a 56-year-old man.

The officer told Glynn afterward, “I couldn’t live with myself if I looked in the eyes of that kid and we didn’t have it.”